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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What are the symptoms of ARLD?

I have been having digestive problems for months - due to, I believe, too much alcohol. As of recently, the diarrhea is constant and I feel very unwell. Could this be signs of ARLD? I stopped drinking 4 days ago, am drinking lots of water to combat dehydration also taking Milk Thistle to help my liver.
Mon, 19 Aug 2019
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Addiction Medicine Specialist 's  Response
Hello,

There are several organs damaged by alcohol. Stomach irritation and ulcer doesn't generally cause diarrhea and does cause ulcers and bleeding.

Damage to the pancreas, however, causes loss of the ability to digest and particularly robust diarrhea. Liver failure causes a lot of problems and the feces loses brown color typically.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Matt Wachsman, Addiction Medicine Specialist
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Addiction Medicine Specialist Dr. Matt Wachsman's  Response
Hello,

I don't know what to tell you about milk thistle except is quite safe. While most studies show a trend to it being helpful,

1) mechanism of action is likely just vitamins and anti-oxidants like in a healthy diet and

2) it does in no way substitute for a specific treatment for the real liver damage (ok "stopped drinking" covers that, but it's used in hepatitis is not as good as hepatitis treatment and people concerned with liver disease should be tested for hepatitis).

Liver problems do not especially cause diarrhea and pancreas injury DOES. it is testable with either very cheap blood tests or pretty cheap ultrasound.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Matt Wachsman, Addiction Medicine Specialist
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Addiction Medicine Specialist Dr. Matt Wachsman's  Response
Hello,

Mostly, none. The liver either has to be VERY ACUTELY IRRITATED which alcohol acute large amounts do.

Most of the symptoms of serious acute liver injury (which would be winding down by 4 days) would preclude being able to typ. So not so much.

OR a LOT of chronic injury. And the liver would certainly have to be more than 50% injured before chronic damage could be found with anything other than MRI or ultrasound.

Probably more like 90%. The liver filters blood and makes stuff. If the liver is shrunken, blood doesn't go through it and backs up. This produces fluid in the belly and often everywhere else.

It is not subtle. Also, veins pop out everywhere behind the liver. Varicose veins, while more common are in most people over age 50 anyway so it isn't linked to liver disease.

Veins popping out on top of the abdomen Literally not just visible but popping out, can only be from ARLD, basically.

The same happens everywhere in the digestive tract and can frequently cause fatal popped blood vessels.

And the liver makes stuff. Starting with clotting proteins, so, seeing how thin the blood is, is an early sign of very bad liver disease.

Filtering out stuff means that drugs accumulate with liver disease and that toxins also accumulate and people turn yellow and feel very bad.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Matt Wachsman, Addiction Medicine Specialist
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